Sister not diagnosed yet but cognitive and physical challenges

Posted by linda @lindakbe, Nov 22, 2023

My sister was alone and 1000 miles away through pandemic. She got very anxious and wanted to live with family. When it was safe we moved her to live close to us. Family doctor added Zoloft to the healthy lifestyle changes. Over three years the anxiety improved but was replaced by increasing problems with memory, difficulties moving around and doing simple things like dressing, sometimes even losing track of where she is or who we are.... doctor approved tapering her off Zoloft thinking there's side effects and now she's at 50 percent of original dose. She's had a brain scan for dementia and findings were "of no concern" and typical of a 70 year old. But she isn't typical ... She's brilliant and funny and well read... but that's getting hidden. She began an exercise and nutrition program and has a usually cheerful attitude. She will begin physical therapy in January. She is scared she will lose her ability to think entirely. A month ago we moved her in with our family because we were concerned for her safety living alone. She is on waiting list for neuropsych exam. But she continues to get worse. Had an exam Monday for ankle edema and double vision. Doctor recommended follow-up with neurology and said she had a Parkinson's look about her but no rigidity or tremors. We do see her hands shake a lot, mostly in morning. Neurology said when is on waiting list for them too. So what can we do other than care for her and love her? I don't want to miss doing something to help her but I'm unsure about how to respond to different situations. And if it is Parkinson's then shouldn't she have medicine or something to keep it from worsening or at least slow it down? Thank you for listening.

Interested in more discussions like this? Go to the Caregivers: Dementia Support Group.

She is almost done with EEG test. Recorded napping now. Things got really exciting when we parked because she starting having symptoms of a heart attack. She got emergency care but thankfully it turned out to be a healthy heart in the body of a terrified woman. Every one is so kind here. And knowing I can bounce into this discussion and gets hugs and info gives me such calm strength.

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@lindakbe

Your words are kind and hopeful. You have woven love so beautifully around your DW. I would write more as a reply but I'm just trying to hang on this morning. We tried to keep my sister awake half the night like the EEG appointment (scheduled for today 12/8)instructions said but it was hard. My son and husband stayed up with us, watching over me watching over her. Everybody is sleepy now! That's not great for navigating a hard day at clinic. She also has a PET scan. I'm concerned as to how she will get through these tests. She said yesterday that she feels like she's being manipulated about these medical details and the tests. And that was an angry time for her. I told her the doctor wants more information to help her best. She calmed down finally.
Her son was able to call and that helped her gain trust about the tests. It's just that every day things seem worse. Tomorrow we will start the Donzole.
Today.... The sun will rise and strength will be found.

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Thank you for the hug! She started having left shoulder pain and numbness as we were parking for her test. Had to get help .... They called all the doctors in hearing and gave paramedic care. Met a lot of nice people. She had her tests! I read EEG results on portal but have no idea what the EEG results mean. I'll have to be patient. Thank you all again

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Good morning my friends!
Does anyone know of a style of slipper/shoe that will protect my sister's feet ? She walks with a shuffle sometimes, especially at night, and currently wears either slip on slippers, which cause her to squeeze up her toes to hold them on and shuffle more, or socks with little nubbies on the bottom for traction. But we don't know if that is going to catch on the floor and cause her to fall.

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Hello everyone!
I don't even know where to start.
Just saw family doctor as first doctor consult since scans. We see neurology on January 22. They're still thinking dementia with Lewy Bodies.
Doc talked about Mayo Palliative Care program but, although she qualifies in 3 areas, she needs to sign a DNR order in case of collapse with no breathing/pulse. But she wants them to do everything to save her and not leave her dying on the floor... Doc very empathetic but said reality is if they resuscitate her with her existing disease, her quality of life will likely be very low. He gave us a packet to fill out. Her son is next of kin and coming out Jan 5-11 to do legal things, POA, etc.
Doc also stopped her Donzole because it was causing extreme weakness and confusion. Or maybe she is just getting worse really quickly.
The third area is my family knows me, and that I love caring for my sister, but I am already utterly exhausted. She gets such comfort from me and calls me every few minutes, and gets angry if I don't drop everything and run to her. I softly tell her she has speak kindly to me. She says sorry. This is so not like her. So sad.
What should we do when her son is here?

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P.S. she also says the aliens are coming for us ... That we should all run and hide . . That she should not feel this way ... But every sentence is said with her eyes closed, in super slow motion, and she wants me to keep listening because she's almost got it... Do I tell her there's no aliens (she was an avid sci Fi reader)? Or is that arguing with her (which of course I don't want to do?)
Should I sit by her side and listen for hours as she talks and dozes? When I try to leave she says wait and keeps slowly talking, one word every few minutes.

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@lindakbe

P.S. she also says the aliens are coming for us ... That we should all run and hide . . That she should not feel this way ... But every sentence is said with her eyes closed, in super slow motion, and she wants me to keep listening because she's almost got it... Do I tell her there's no aliens (she was an avid sci Fi reader)? Or is that arguing with her (which of course I don't want to do?)
Should I sit by her side and listen for hours as she talks and dozes? When I try to leave she says wait and keeps slowly talking, one word every few minutes.

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Linda, My heart goes out to you. It sounds like your sister's condition is progressing rapidly. It is great that her son is coming soon. Has he seen her recently, or is he going to be shocked when he comes?
Is he the type that will step in and help with the legal matters? If so, can he, or you, or another family member locate an eldercare attorney near you and set up an appointment early in his visit?
It sounds to me, from your descriptions of events this month, that it may be time for Legal and Durable Medical Power of Attorneys, or even a guardianship. Encourage him to take an active role in this if he can - please do not add the burden of making critical decisions and dealing with finances to your already overflowing plate!
At the end of my Mom's life, even though she was still fairly competent, my brother held her Financial/Legal Power of Attorney and sister and I jointly held her Medical Power of Attorney, so we could make decisions together about her care (there are 6 kids, the rest were okay with the arrangement.)
Definitely invite him to all medical appointments so he can hear first hand what her doctors advise.
Please come back and chat here - we will hold your hand remotely as you travel through this difficult time.
Sue

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Linda
Delusions and hallucinations are common with Lewy Body. It is futile and not helpful to try to convince them they are not real. To them they are very real. Someone suggested to me to simply and calmly assure your LO that you love them and will protect and care for them from anything that comes along. This has worked for us most of the time. There are some meds that can take the edge off the delusions and/or hallucinations if they are really bothersome. You can check with neurologist. My DW also wants me to sit right beside her all day. I have found telling her to "hold that thought a minute" I have to go do something (could be anything) and I'll be right back. By the time I get back she has forgotten about it. I know this is all happening fast for you, but you have good instincts on caring for your sister. Breath, you are doing great and she is lucky to have you there.

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@lindakbe

Good morning my friends!
Does anyone know of a style of slipper/shoe that will protect my sister's feet ? She walks with a shuffle sometimes, especially at night, and currently wears either slip on slippers, which cause her to squeeze up her toes to hold them on and shuffle more, or socks with little nubbies on the bottom for traction. But we don't know if that is going to catch on the floor and cause her to fall.

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My suggestion about slippers for your sister: she might be better off wearing slippers with a hard sole but not slip-ons, the ones you have to put your entire foot in.

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@sueinmn

Linda, My heart goes out to you. It sounds like your sister's condition is progressing rapidly. It is great that her son is coming soon. Has he seen her recently, or is he going to be shocked when he comes?
Is he the type that will step in and help with the legal matters? If so, can he, or you, or another family member locate an eldercare attorney near you and set up an appointment early in his visit?
It sounds to me, from your descriptions of events this month, that it may be time for Legal and Durable Medical Power of Attorneys, or even a guardianship. Encourage him to take an active role in this if he can - please do not add the burden of making critical decisions and dealing with finances to your already overflowing plate!
At the end of my Mom's life, even though she was still fairly competent, my brother held her Financial/Legal Power of Attorney and sister and I jointly held her Medical Power of Attorney, so we could make decisions together about her care (there are 6 kids, the rest were okay with the arrangement.)
Definitely invite him to all medical appointments so he can hear first hand what her doctors advise.
Please come back and chat here - we will hold your hand remotely as you travel through this difficult time.
Sue

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Thank you, Sue, for your helpful compassion. Her son is going to be in charge of all her financial and legal issues.... I am going to be in charge of her day to day care and getting her to all her appointments (with the help of my sons, daughters, and husband). My nephew is very interested in conferencing in on all her appointments that are consultations, and has been doing so since his mom got sick. He calls her and comforts her in so many ways. He saw her at Thanksgiving, and even though I kept him up to date with her health issues with daily, detailed text messages, he was shocked to see her weakness and decline at Christmas.
He will have legal power of attorney, and medical power of attorney. I hope he will let me be joint on the medical POA because I may have to make decisions quickly ... do you agree?
She has stopped the medicine that was ?causing side effects of extreme weakness and confusion. She has improved a lot in that way, almost pre-medicine in most areas. But she is having hallucinations ... for example, she said she was scared of how my legs look.... she saw legs that had no skin and could see all my bones and muscles. It is so very hard to see her fall apart like this. But she retains her sense of humor.... she is truly a delightful woman in so many ways.
Tomorrow we start physical therapy twice a week. I hope that goes well.
Thank you again for being here. My whole family is super worried about me and really encourage me to have your support through this. (I had cancer a decade ago, and they are quite protective over me.)

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@lindakbe

Thank you, Sue, for your helpful compassion. Her son is going to be in charge of all her financial and legal issues.... I am going to be in charge of her day to day care and getting her to all her appointments (with the help of my sons, daughters, and husband). My nephew is very interested in conferencing in on all her appointments that are consultations, and has been doing so since his mom got sick. He calls her and comforts her in so many ways. He saw her at Thanksgiving, and even though I kept him up to date with her health issues with daily, detailed text messages, he was shocked to see her weakness and decline at Christmas.
He will have legal power of attorney, and medical power of attorney. I hope he will let me be joint on the medical POA because I may have to make decisions quickly ... do you agree?
She has stopped the medicine that was ?causing side effects of extreme weakness and confusion. She has improved a lot in that way, almost pre-medicine in most areas. But she is having hallucinations ... for example, she said she was scared of how my legs look.... she saw legs that had no skin and could see all my bones and muscles. It is so very hard to see her fall apart like this. But she retains her sense of humor.... she is truly a delightful woman in so many ways.
Tomorrow we start physical therapy twice a week. I hope that goes well.
Thank you again for being here. My whole family is super worried about me and really encourage me to have your support through this. (I had cancer a decade ago, and they are quite protective over me.)

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Linda - It is a rare family that makes such a comprehensive plan. Kudos to you, your nephew, husband and kids!
I personally like the idea of aa joint medical POA because decisions often need to be made on the fly. I remember making decisions about my Grandma when my parents were away and left my sister and me - ages 25 & 30 - in charge. Neither of us would have wanted to do it alone!

Funny somehow, but even though I spent my career in technology. I was thinking last week how long I have been involved in care-giving - I remember helping my Dad with my Great-Uncles and Aunts as early as the age of 9, continued with grandparents, neighbors, parents, in-laws, and now at 72 I still talk to people about it...I know my kids will be there for us - they are already involved with their own friends and neighbors.

Tell your family, over and over, how much you appreciate their help and support - it is a rare quality.
And yes, we will always try to be there for you - as their backup.
Sue

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